Madison, Wisconsin - An American Family Children's Hospital oncologist said better care coordination for childhood-cancer survivors transitioning to adult care could further improve long-term survival rates.

Dr. Diane Puccetti is director of the Caring for Life Clinic, which educates childhood cancer survivors about late effects of cancer treatment and how to advocate for themselves as they become adults. The clinic offers a wide range of specialists to care for the physical and emotional health of childhood cancer survivors.

She said despite recently reported, improved survival rates, patients sometimes suffer late effects from cancer treatments like chemotherapy and radiation.

A study headed by St. Jude's Research Hospital that was presented last month at a meeting of the American Society of Clinical Oncology followed 34,000 five-year childhood cancer survivors. The study showed that deaths dropped from 12 percent in the early 1970s to six percent in the early 1990s. During the same time period, 41 percent of the 4,000 deaths reported in the study were related to late effects.

"Cancer survivors can develop secondary cancers, cardiac and lung problems and other complications as adults," said Puccetti. "We have to educate childhood cancer survivors about their risks for long-term late effects so that they can advocate for appropriate health screenings as they transition to adult care."

Puccetti said while cancer treatments are still toxic and put patients at risk for health complications as adults, improvements have been made. Radiation is more targeted and less harmful to normal cells and new chemotherapy drugs have been developed.

"We'll never eliminate all risks," said Puccetti. "But we continue to make advancements in improving long-term survival."

She said there are still things that we don't know about development of late effects.

"We don't know who is at risk for late effects," said Puccetti. "Studies are underway to see if there are genetic reasons for health complications as adults."

Puccetti said the Caring for Life Clinic hopes to bridge gaps that many childhood cancer survivors face. The multidisciplinary team finds the work satisfying.

"For all of us, we have a lot of joy when we see children grow up emotionally and physically and take on their disease," said Puccetti. "It's really rewarding to be part of that process."

Date Published: 06/29/2015

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